What Happens When You Sign a Private Contract Outside of Medicare

Medicare providers must be approved by Medicare to provide you services and agree to the terms that Medicare sets forth. If you agree to be treated by someone that is not a part of Medicare this is a private contract that may not get some of the benefits of a regular contract. Here are some things to consider.

• Medicare won’t pay any amount for the services you get from this doctor or provider, even if it’s a Medicare-covered service.

• You will have to pay the full amount of whatever this provider charges you for the services you get.

• If you have a Medicare Supplement Insurance (Medigap) policy, it won’t pay anything for the services you get. Call your insurance company before you get the service if you have questions.

• Your provider must tell you if Medicare would pay for the service if you got it from another provider who accepts Medicare.

• Your provider must tell you if he or she has been excluded from Medicare.

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